Angelic Advance Support Coordinator
Supports Brokerage in Jersey City, NJ. Organization (NPI-2).
NPI number1346015427
StatusActive
Last updated in NPPESDec 3, 2023
Details
- NPI
- 1346015427
- Entity type
- Organization (NPI-2)
- Legal business name
- Angelic Advance Support Coordinator
- Organization subpart
- No
- Enumeration date
- Nov 20, 2023
- Certification date
- Dec 3, 2023
- Last updated
- Dec 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251X00000X | Supports Brokerage | – | – | Yes |
| 305S00000X | Point of Service | – | – | |
| 251B00000X | Case Management | – | – | |
| 251C00000X | Day Training, Developmentally Disabled Services | – | – | |
| 251K00000X | Public Health or Welfare | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QA0600X | Clinic/Center, Adult Day Care | – | – |
Practice location
399 2nd St Apt 3rJersey City, NJ 07302-2248
Phone 319-300-0095
Mailing address
1107 Cameron RdEffort, PA 18330-2301
Phone 319-464-1188
Authorized official
Neema John Mushi
Ceo
3193000095
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